Specialist Nurses in Europe: Where Do We Stand? - European Medical Journal

Specialist Nurses in Europe: Where Do We Stand?

2 Mins
*Françoise Charnay-Sonnek
EMJ Hepatol. ;5[1]:60-62. Abstract Review No. AR11.
Nurse specialist, advanced practice nursing, recognition at European level, common training framework, mobility, security and quality of care

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Nurses and specialist nurses are playing a growing role in the healthcare system. Alongside the specialities already existing, such as nurse anaesthetists, operating room nurses, intensive care nurses, mental health nurses, and paediatric nurses, new specialties have also emerged, or are about to emerge, such as cancer nurses, endocrinology nurses, diabetes nurses, and cardiology nurses.

Despite the fact that formal training for certain specialties has existed for years, practice, status, training duration, and content may be drastically different from one country to another. Some other specialist roles have been established in Europe, with a professional transnational collaboration, including diabetes, dialysis, urology, and oncology. Moreover, the development of higher medical technologies and more sophisticated treatment requires specialist nurses.

According to the World Health Organization’s (WHO) ‘Health 2020. A European policy framework and strategy for the 21st century’, health for all should be improved and health inequalities reduced.1 We can observe a higher demand for healthcare services and physician-specialists alone cannot respond to this demand; therefore, nurse specialists have a role to play. Nevertheless, their role is still not homogeneously defined across Europe.2-7 There is no mention of nurse specialists in the European directive 55/2013/EU8 on the recognition of the professional qualification and there is no harmonisation in terms of education, practice, and status.

ESNO is committed to recognising nurse specialists at the European level. We represent the interests of the member organisations and we provide expert advice and share best practice on issues shaping specialism in nursing. Our scope of interventions is large and includes advocacy, education, lobbying, and contributing to different actions run by European organisations, institutes, and agencies. FEND and ESNO are leading a survey titled ‘Nurse specialists in Europe Definition of a Common Diabetes Nurse Specialist Training Framework- a Feasibility Study (DiaFram)’. We have started with the specialty of diabetes, but the study corpus can be duplicated to other specialties, in order to allow them to develop their own common training framework according to their own specificities.

Our long-term strategies aim to set the status of nurse specialists in the healthcare arena at master’s, post-master’s, and doctoral level with an automatic recognition of their qualification. The harmonisation of practice and scope of competences is essential to permit mobility at a pan-European level and, last but not least, to ensure the security and quality of the care.

ESNO’s members consist of individual European specialist nurses, and the number of members is still growing. Today, we number 15 members representing different specialties:9

  • Association for Common European Nursing Diagnoses, Interventions and Outcomes (ACENDIO)
  • European Dialysis and Transplant Nurses Association/European Renal Care Association (EDTNA/ERCA)
  • European federation of Critical Care Nursing associations (EfCCNa)
  • European Nurse Directors Association (ENDA)
  • European Oncology Nursing Society (EONS)
  • European Operating Room Nurses Association (EORNA)
  • Foundation of European Nurses in Diabetes (FEND)
  • International Federation of Nurse Anesthetists (IFNA)
  • European Association of Urology Nurses (EAUN)
  • European Society of Gastroenterology and Endoscopy Nurses and Associate (ESGENA)
  • European Respiratory Nurses Association (ERNA)
  • European League Against Rheumatism/Nurses section (EULAR)
  • European Society for Emergency Nursing (EuSEN)
  • European Association of Neuroscience Nurses
  • European Veterinary Nurses


  • European Society of Endocrinology Nurses (ESE)
  • European Conference on Mental Health (ECMH)
  • IBD, Inflammatory Bowel Diseases


  • Skin and Dermatology Nurses Europe
World Health Organization. Health 2020: the European policy for health and well-being. Available at: http://www. euro.who.int/en/health-topics/health-policy/health-2020-theeuropean-policy-for-health-and-well-being/about-health-2020. Last accessed: 15 May 2017. Dury C et al. Specialist nurse in Europe: education, regulation and role. Int Nurs Rev. 2014;61(4):454-62. LaSala CA et al. The role of the clinical nurse specialist in promoting evidence-based practice and effective positive patient outcomes. J Contin Educ Nurs. 2007;38(6):262-70. Delamaire M, Lafortune G. Nurses in Advanced Roles: A Description and Evaluation of Experiences in 12 Developed Countries. OECD Health Working Papers. 2010;54. DOI: 10.1787/18152015. NACNS (National Association of Clinical Nurse Specialists) Impact of the clinical nurse specialist role on the costs and quality of healthcare: policy briefing paper (December, 2013). Clin Nurse Spec. 2014;28(5):300-3. DeJong SR, Veltman RH. The effectiveness of a CNS-led community-based COPD screening and intervention program. Clin Nurse Spec. 2004;18(2):72-9. Gardner G et al. Identifying advanced practice: A national survey of a nursing workforce. Int J Nurs Stud. 2016;55:60-70. EUR-Lex. Directive 2013/55/EU (2013) Directive 2013/55/EU of the European Parliament and of the Council of 20 November 2013 amending Directive 2005/36/EC on the recognition of professional qualifications and Regulation (EU) No 1024/2012 on administrative cooperation through the Internal Market Information System ( ‘the IMI Regulation’ ) Text with EEA relevance. Available at: http://eur-lex.europa.eu/legal-content/ EN/ALL/?uri=celex%3A32013L0055. Last accessed: 15 May 2017. European Specialist Nurses Organisation. Available at: www. esno.org. Last accessed: 15 May 2017.

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